Local Health Departments

Counseling

Using the instructions and the standing order template on this page North Carolina Local Health Departments can bill health care payors for tobacco cessation counseling. Download both documents, use the template to create your health department's standing order, and follow the instructions to be reimbursed for providing tobacco treatment services.

• Billing for Tobacco Cessation Counseling in North Carolina: Local Health Departments
• Standing Order for Tobacco Cessation Counseling in North Carolina Local Health Departments (DOCX, PDF)

Pharmacist-Dispensed Nicotine Replacement Therapy (NRT)

How It Works: No Doctor Needed

North Carolina has established statewide protocols through the NC Board of Pharmacy that allow authorized pharmacists to prescribe and dispense all FDA-approved Nicotine Replacement Therapy (NRT) products.

This means your patients can get essential quit-tobacco medications directly from their local pharmacy without needing a doctor's appointment. This removes a significant barrier to accessing treatment.

Key Document: View the official Nicotine Replacement Therapy Protocol for full details.

Immunizing Pharmacist Enrollment & Medicaid Billing

• The NC Board of Pharmacy protocols authorize immunizing pharmacists (those certified to administer immunizations) to dispense, deliver, or administer NRT.
• To Bill NC Medicaid for Dispensing NRT per protocol, the immunizing pharmacist must:
  • Enroll as an NC Medicaid provider using the Ordering, Prescribing, Referring (OPR) Lite application.
  • Use their NPI (National Provider Identifier) as the prescriber on pharmacy claims for the NRT product.
  • Use their NPI as the ordering provider on medical claims for any associated clinical services.

Over-the-Counter NRT and Medicaid Coverage

Over-the-Counter NRT and Medicaid Coverage

When recommending or prescribing over-the-counter NRT (patches, gum, or lozenges) for patients with NC Medicaid, you must ensure the selected product is rebatable and covered.

Medicaid plans are legally required to cover rebatable NRT products, but using the wrong product code (National Drug Code or NDC) can cause billing issues and prevent your patient from receiving their covered medication.

How to Ensure NRT is Covered for the Patient

Use the NC Tracks Search Bar to look up approved products:

1. Access the Search Tool: Click this SEARCH BAR.
2. Filter Results: Check the "rebatable" option.
3. Search: Type "Nicotine" in the search field.
4. Review: An exportable list of Medicaid-covered NRT brands will be provided.

⚠️ Important: The list of covered products can change, so check back periodically to ensure accuracy.

Prescribing for Medicaid Recipients

To prevent confusion at the pharmacy and ensure your patient receives a covered product, follow one of these two recommended strategies when writing a prescription:

1. Direct Communication: Call the patient's chosen pharmacy and tell them to use one of the NDC-approved nicotine replacement options from the covered list. OR
2. Add a Note to the Prescription: Include the following instructions in the "Notes to Pharmacy" section of your NRT prescription for Medicaid recipients: "Pharmacy - Please fill with a Medicaid-covered NDC. For a current list, call NC Tracks at 1-800-688-6696."